ABPM-CONTROLLED ANTIHYPERTENSIVE THERAPY AND ITS EFFECT ON LEFT-VENTRICULAR HYPERTROPHY

A trial was conducted to answer the question if the antihypertensive a gent quinapril administered under the control of 24-hour ambulatory bl ood pressure monitoring (ABPM) in patients with mild hypertension and left ventricular hypertrophy (LVH) have favorable effects on the regre ssion of LVH. All the 46 patients studied had echocardiographically pr oven LVH. They were treated with quinapril for 6 months. Echocardiogra ms, ABPMs, and 24-hour electrocardiograms were performed before the st art of treatment and again at 1, 3 and 6 months. Within the first mont h of therapy, mean 24-hour systolic pressure decreased from 151,4 mmHg to 130,8 mmHg and mean 24-hour diastolic blood pressure decreased fro m 93,7 mmHg to 80,2 mmHg. After 6 months of quinapril therapy, septal wall thickness decreased by 22,3%, posterior wall thickness by 25,8%, and left ventricular mass by 25,9%. In this study, administration of q uinapril, monitored by ABPM, led to an enhanced regression of LVH when compared with the regression of LVH in the meta-analysis of Dahlof et al. Possible causes are: 1. the greater extent of LVH in our study, 2 . the better control of high blood pressure by ABPM, 3. the high affin ity of quinapril for cardiac tissue ACE.